P3.199: Sleep in parents of newborns: Associations with bonding

Background: The parent-to-infant bond is an important emotional connection. Poor bonding is associated with negative developmental and mental health outcomes in children, as well as negative parental mental health. One contributor to bonding may be sleep, however few studies have investigated the relationship of newborn and parent sleep with bonding.

Methods: 125 parents (96.8% mother) of newborns (2-6 wks; M =4.4 wks) completed the Postpartum Bonding Questionnaire (PBQ, lower scores indicate increased bonding), the Brief Infant Sleep Questionnaire–Revised (BISQ-R), PROMIS Sleep Disturbance (SDi) and Sleep-Related Impairment (SRI) scales with additional sleep pattern questions, and Brief Mood Introspection Scale (BMIS; range from -10 very unpleasant to 10 pleasant).

Results: Bonding scores (PBQ) ranged from 0 to 29 (M=8.3, SD=7.0), with mood scores averaging 6.1 (SD=3.5). Overall, 46.4% (n=58) of parents reported that their neonate’s sleep was a problem. Sleep disturbance (SDi; mean T score=54.7, SD=6.2) was elevated for 12% (n=15) of parents, and sleep related impairment (SRI; mean T score=56.7, SD=7.7) was elevated for 39.2% (n=49).

Poorer bonding as represented by higher PBQ scores was associated with parental daytime sleep related impairment (SRI; r=.38, p<.001), less daytime sleep (r=-.24, p<.01), less sleep per 24h (r=-.20, p<.05), and unpleasant mood (r=-.48, p<.001). No associations were found between bonding and parent sleep disturbances or nighttime sleep patterns, including bedtime, sleep onset latency, nighttime awakenings and nighttime sleep duration. Similarly, there was no association with newborn nighttime or daytime sleep patterns.

However, more difficulty with bonding was associated with poorer parent perception of newborn sleep, including perceiving their newborn’s overall sleep was a problem (r=.35, p<.001), nighttime sleep was a problem (r - .31, p<.001), bedtime difficulty (r=.32, p<.001), less enjoyment getting the baby ready for bed (r=-.64, p<.001), and perception that their baby slept poorly (r=.26, p<.01). Similarly, poorer bonding was associated with negative perceptions of newborn daytime sleep, including that naps were a problem (r=.30, p<.001), difficulty at naptime (r=.21, p<.05) perception that the baby slept poorly for naps (r=.30, p<.01), and was fussier after nap (r=.28, p<.01). Finally, more trouble bonding was related to being less confident in managing newborn sleep (r=.41, p<.001) and for naps (r=.36, p<.001).

Conclusion: Overall, poorer bonding is related to parents’ poorer daytime functioning, including unpleasant mood, daytime sleepiness/fatigue, and less daytime sleep. Thus, there is a strong relationship between bonding and enjoyment. Interestingly, no relationships were found with newborn sleep patterns or parent nighttime sleep patterns. In addition to addressing parental overall mood, pediatricians may want to problem solve with parents of newborns ways to get more sleep and assistance during the day to potentially help with bonding.